| NPI | 1235198581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G49498) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 46578) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2013-03-26 |